Provider Demographics
NPI:1811462922
Name:NJIKEM EUNICE, NJILEFAC (HHA)
Entity type:Individual
Prefix:
First Name:NJILEFAC
Middle Name:
Last Name:NJIKEM EUNICE
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:NJILEFAC
Other - Middle Name:EUNICE
Other - Last Name:NJIKEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7865 RIVERDALE RD APT 202
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-4033
Mailing Address - Country:US
Mailing Address - Phone:313-614-5831
Mailing Address - Fax:
Practice Address - Street 1:7865 RIVERDALE RD APT 202
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-4033
Practice Address - Country:US
Practice Address - Phone:313-614-5831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13852374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide